Antibiomania: a case report of clarithromycin and amoxicillin-clavulanic acid induced manic episodes separately

Article Article scientifique Rapport de cas Antibiomania: a case report of clarithromycin and amoxicillin-clavulanic acid induced manic episodes separately eng 2021-08-11 2021-08-11 author Mészáros Edith Paula 931956 author Stancu Catheline 778894 author Costanza Alessandra 0000-0001-6387-6462 814969 author Besson Marie 87576 author Sarasin François 65003 author Bondolfi Guido 0000-0002-4352-5531 135439 author Ambrosetti Julia 0000-0002-5775-4589 864890 399 10.1186/s12888-021-03397-7 34380446 1471-244X PMC8359544 https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-021-03397-7 Background: Antibiomania is a rare but recognized side effect with yet unclear definite pathogenesis although multiple hypotheses have been proposed. The novelty of this case is the suspected pharmacodynamic drug-drug interaction between clarithromycin and amoxicillin-clavulanic acid. Case presentation: We present the occurrence of a brief manic episode concerning a 50-year-old man with no psychiatric history, first started on amoxicillin-clavulanic acid therapy and then switched to clarithromycin for left basal pneumonia. Shortly after the antibiotic prescription, he presented psychiatric symptomatology (logorrhea, elevated mood, irritability, increase in physical activity and delusions). The antibiotic was stopped and the patient received lorazepam (2.5 mg p.o.) to treat psychomotor agitation. Approximately 12 h after clarithromycin cessation, amelioration was already observed, supporting the diagnosis of a clarithromycin-induced manic episode. Amoxicillin-clavulanic acid was then reintroduced because of the pneumonia and psychiatric symptoms reemerged. This second antibiotic was also stopped, and 1 week later, the patient was symptom-free. Conclusion: The emergence of psychiatric side effects related to antibiotherapy, which is a common treatment, can greatly impact a patient's quality of life. Early recognition and intervention could substantially influence the administered medical care and recovery. Moreover, given the widespread use of antibiotics including in combination, we thought our case report might be clinically useful as a clinical reminder relevant to the use of antibiotic combinations. Adverse effects Amoxicillin-clavulanic acid Antibiomania Antibiotics Case report Clarithromycin Mania Dewey 616.89 Dewey 617 60 Département de psychiatrie 225 63 Département d'anesthésiologie, pharmacologie, soins intensifs et urgences 229 false 302 Groupe Desmeules Jules (pharmacologie/toxicologie) 567 17 Médecine d'urgence 24 418 Médecine psychosomatique, neurosciences cliniques et mindfulness 690 BMC psychiatry 21 1 6e7579b1-12c8-4afd-a53c-a9789f5b2283 Article (Published version) Public Article-scientifique-from-unpaywall.pdf 493161 application/pdf CC BY-4.0 openAccess Faculté de médecine / Section de médecine clinique / Département de psychiatrie Faculté de médecine / Section de médecine clinique / Département d'anesthésiologie, pharmacologie, soins intensifs et urgences

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Antibiomania: a case report of clarithromycin and amoxicillin-clavulanic acid induced manic episodes separately	BMC psychiatry			2021	491	348

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Mészáros, Edith Paula